Project Summary/Abstract: Ongoing concerns about the management of children's pain and its treatment make pain assessment in children a high medical priority. Currently, the dominant clinical technique has children indicate pain by selecting from among a set of static, stylized facial expressions that represent different degrees of pain. Although the widespread use of such methods has yielded substantial clinical information, these so-called "face scales" can only show a small number of facial expressions (6 or 7), do not allow the user to fine-tune ratings, and do not provide for automatic computer storage and data analysis. The objective of this Phase I proposal is to develop a computerized method for assessing pain by having a child adjust a cartoon face whose expression can range continuously from a frown to a smile. This software is referred to as the Children's Computer Assessment of Pain (C-CAP), and it has been successfully tested in preliminary work with hospitalized children and with a comparable group of healthy children. The results of this preliminary work are promising and encourage further development. The purpose of the 2 studies proposed here is to collect data on the C-CAP's psychometric properties of test-retest reliability, concurrent validity, and acceptance through the testing of 120 patients in 2 hospitals (1 rural, 1 urban) that provide specialized care for children. PROPOSED COMMERCIAL APPLICATIONS. There are excellent commercial prospects for computer software that allows children to rate their level of pain. Such a method could also prove useful for testing adults with limited language skills, and in cross-cultural situations where the impact of language differences must be negated. Once the software package is implemented and tested, site licenses for the program will be sold to clinics and hospitals, as well as to pharmaceutical companies conducting clinical trials both in the US and internationally. Project Narrative: The objective of this project is to evaluate a new computerized method that allows children (patients) to express their pain by adjusting and fine-tuning the emotional expression of a cartoon face. This type of information will assist nurses and other health care providers in determining the most appropriate treatment for children in pain. [unreadable] [unreadable] [unreadable]